Transmission: Through contact transmission, infected
mucous droplets are taken into the mouth and/or nose of the patient. The
droplets adhere to the oro- and nasopharynx epithelial cells and enter the
bloodstream through the mucosal/blood barrier (4).

Reservoirs: Approximately 10% of the population
carries N. meningitides in their oro- and nasopharnyx which provides a
constant reservoir for the disease (2).

General Characteristics: Gram-negative, endotoxin
producing, diplococci with flattened sides that has several different serotypes
that are distinguished according to their polysaccharide capsule (4).

Identification Tests: N. meningitides is a
Gram negative diplococcus that is oxidase positive and can ferment glucose and
maltose but not lactose and sucrose. Specimens are sampled from either the blood
or the cerebrospinal fluid (5).

Signs and Symptoms: A patient will be profoundly
febrile, usually with cervical rigidity, and present with some form of
neurological signs/symptoms (seizures - focal motor and/or grand mal, alteration
of awareness, flaccidity of muscles, lethargy, photophobia) as result of an
increase in intracranial pressure. Nausea/vomiting and headache are also common
findings. The most ominous sign, however, are petechiae, purpura, and/or skin
lesions/skin rash in high friction areas (skin folds, beltline, etc.) (2).

Historical Information:

Virulence Factors: N. meningitides has an
antiphagocytic polysaccharide capsule as well as an endotoxin as part of its
cell wall composition (4).

Control/Treatment: Patients receiving treatment in a
hospital should be kept in isolation with strict use of PPE until 24 hours after
the initiation of appropriate therapy. Most patients require the administration
of chemoprophylactics such as rifampin in conjunction with penicillin or
cephalosporin (patients allergic to penicillin) (2).

Prevention/Vaccine: The Meningococcal Polysaccharide
Vaccine (MPSV4) is formulated to attack the different polysaccharide capsules of
serotypes A, C, Y, and W135 and is currently implemented in the United States to
treat epidemics and populations with a high rate of contraction susceptibility
(college dorms, sleep-away camps, and boarding schools, etc.). However, this
vaccine is ineffective in the prevention of the disease in children under 2
years of age. Currently the Meningococcal Conjugate Vaccine (MCV4) covers the
above mentioned serotypes, as well, and is licensed in the United States for
people age 2 -55 years (1).

Local Cases or Outbreaks: There are approximately
1,400 to 2,800 documented cases of meningococcal meningitis in the United States
annually (1).

Global Cases or Outbreaks: The prevalence of
meningitis abroad, especially in some regions of Africa have been a major source
of alarm with more than 2,000 cases reported thus far in 2008 (3).

5. WHO
Collaborating Center for Prevention and Control of Epidemic Meningitis.
Laboratory Methods for the Diagnosis of Meningitis Caused by Neisseria
meningitides, Streptococcus pneumoniae, and Haemophilus influenzae.
Center for Disease Control and Prevention.
http://www.cdc.gov/meningitis/downloads/meningitis_manual.pdf. December 6th,
2008.